Pressure ulcers are a significant healthcare problem that not only leads to severe patient outcomes but also affects the quality of nursing practice negatively. According to Gaspar et al. (2019), today, hospital-acquired pressure ulcers are a critical issue, and a specific setting has a significant impact on its frequency. This work aims to determine whether microclimate controlling plus patient position movement is an effective tool as a quality improvement initiative compared with only moving the patient position to reduce the prevalence of pressure ulcers.
Context of the Initiative
Since pressure ulcers are usually caused by patient immobility, an intensive care unit is an appropriate setting for the proposed initiative. Tran et al. (2016) state that in these departments, annually, an average of about $11 billion is spent on preventing the issue (p. 232S). Beal and Smith (2016) confirm the relevance of the problem and note nursing reports that describe the challenges of addressing the issue in the proposed setting. In this regard, an intensive care unit is a suitable setting to conduct the necessary assessment of the effectiveness of the proposed improvement initiative.
Quality Initiative Description
Addressing the issue of pressure ulcers in immobile patients by combining traditional patient position movement practices and microclimate controlling has potentially high success rates. As van Leen et al. (2018) note, the conditions in which a patient undergoes care, in particular, temperature and humidity, determine the condition of the skin. In addition, Arfah et al. (2020) draw attention to such an accompanying nuance as the quality of bedding and emphasize the importance of choosing the optimal materials. Therefore, cumulative measures have a high likelihood of successful preventive actions.
Effect of the Quality Initiative
The proposed quality initiative has value as an intervention that can reduce the likelihood of pressure ulcers in acute care units. Kottner et al. (2018) argue that human skin reacts instantly to any changes in the microclimate, including humidity and temperature. This means that control over these parameters, which is supplemented by appropriate patient position movements, can help eliminate environmental influences and eliminate pressure ulcers that develop in inappropriate microclimate conditions.
Implications for Nursing Practice
The importance of implementing the considered quality initiative is due not only to potentially higher patient outcomes but also to positive impacts on nursing practice. According to Kalowes et al. (2016), the number of hospital-acquired pressure ulcers is one of the performance indicators of nursing staff. Consequently, the lower is this level, the more productive is the work of nurses, and the higher is the likelihood of popularizing the effective intervention in the proposed clinical environment.
Solution to the Issue
Combining microclimate controlling and patient position movement is a potentially effective solution to reducing pressure ulcers in intensive care units. Along with other researchers, Zeevi et al. (2017) confirm the value of controlling such microclimate indicators as temperature and humidity and note that for the nursing field, the introduction of such a technique has valuable implications. Minimizing the incidence of hospital-acquired pressure ulcers makes it possible to focus on comprehensive patient care and improves the quality of the work of the medical staff, which are valuable prospects.
Conclusion
The proposed quality initiative suggests combining patient position movement with microclimate controlling as an effective mechanism for minimizing pressure ulcers in patients in intensive care units. The issue of hospital-acquired pressure ulcers has numerous severe implications for the target audience and nurses. Regulating humidity and temperature parameters contributes to a faster adaptation of the skin to immobility. The value of this intervention for nursing practice is significant since more time for professional activities appears, which, in turn, increases the quality of care.
References
Arfah, A., Yusuf, S., & Syam, Y. (2020). The role of textiles in controlling microclimate to prevent pressure injury. Media Keperawatan Indonesia, 3(2), 81-89. Web.
Beal, M. E., & Smith, K. (2016). Inpatient pressure ulcer prevalence in an acute care hospital using evidence‐based practice. Worldviews on Evidence‐Based Nursing, 13(2), 112-117. Web.
Gaspar, S., Peralta, M., Marques, A., Budri, A., & Gaspar de Matos, M. (2019). Effectiveness on hospital‐acquired pressure ulcers prevention: A systematic review. International Wound Journal, 16(5), 1087-1102. Web.
Kalowes, P., Messina, V., & Li, M. (2016). Five-layered soft silicone foam dressing to prevent pressure ulcers in the intensive care unit. American Journal of Critical Care, 25(6), e108-e119. Web.
Kottner, J., Black, J., Call, E., Gefen, A., & Santamaria, N. (2018). Microclimate: A critical review in the context of pressure ulcer prevention. Clinical Biomechanics, 59, 62-70. Web.
Tran, J. P., McLaughlin, J. M., Li, R. T., & Phillips, L. G. (2016). Prevention of pressure ulcers in the acute care setting: New innovations and technologies. Plastic and Reconstructive Surgery, 138(3S), 232S-240S. Web.
van Leen, M., Halfens, R., & Schols, J. (2018). Preventive effect of a microclimate-regulating system on pressure ulcer development: A prospective, randomized controlled trial in Dutch nursing homes. Advances in Skin & Wound Care, 31(1), 1-5. Web.
Zeevi, T., Levy, A., Brauner, N., & Gefen, A. (2017). Effects of ambient conditions on the risk of pressure injuries in bedridden patients – Multi‐physics modelling of microclimate. International Wound Journal, 15(3), 402-416. Web.